Barbiturates: Definition, Types, Uses, Side Effects & Abuse

They are also used for day long sedation for people being treated for anxiety. When used with other drugs, long-acting barbiturates are used to control the pain from migraine headaches and to treat convulsive disorders like epilepsy. The prolonged use of barbiturates—especially secobarbital and pentobarbital—may cause the development of a tolerance to them and require amounts much larger than the original therapeutic dose. Denial of a barbiturate to the habitual user may precipitate a withdrawal syndrome that is indicative of physiological dependence on the drug.

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In the medical profession, this difference is called a narrow therapeutic index, which is the ratio of a drug’s toxic dose to its therapeutically desirable dose. Although the medical use of barbiturates has declined since the 1970s, high school surveys suggest misuse has been rising over the last 10 years. A common reason to misuse barbiturates is to counteract the symptoms of other drugs; the barbiturates (“downers”) counteract the excitement and alertness obtained from stimulant drugs like cocaine and methamphetamines. Barbiturates can be extremely dangerous because the correct dose is difficult to predict. Barbiturates are also addictive and can cause a life-threatening withdrawal syndrome. Never combine barbiturates with other depressant medications, including alcohol, and call 911 immediately if you suspect an overdose.

What are the advantages of these medications?

They can also serve as backup when the first-line medications don’t work.

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Barbiturates have been used historically to treat insomnia and psychiatric disorders, provide anesthesia, and manage alcohol withdrawal, elevated intracranial pressure, and seizures. Once extremely popular for a broad spectrum of indications in the late 20th century, the use of these drugs has declined mainly in favor of agents with more favorable safety profiles. However, barbiturates are still prescribed or obtained illicitly, and their misuse, whether intentional or not, can lead to grave harm or death.

It is said that on St. Barbara’s day in 1864, he developed a compound from urea and malonic acid (a chemical found in apples). He called this new compound barbituric acid, in honor of St. Barbara. Physical dependence is characterized by a compelling craving for the drug and by withdrawal symptoms when the drug use stops. The results of certain medical tests may also be affected by barbiturates, so it is important for people who take them to inform the attending health care professional before any tests are performed.

Barbiturates Addiction & Abuse

An overdose of barbiturates can result in coma and even death due to severe depression of the central nervous and respiratory systems. One of the most important advantages of barbiturates is how long they last. Some of these medications are only effective for a very brief time.

However, most barbiturate use has been replaced by the development of newer, safer, alternative drugs. In the late 1950s and 1960s, there was an increase in reports of barbiturate overdoses and dependence problems, and physicians stopped prescribing them. In the late 1950s and 1960s, an increasing number of published reports of barbiturate differences between crack and cocaine and myths overdoses and dependence problems led physicians to reduce their prescription, particularly for spurious requests. This eventually led to the scheduling of barbiturates as controlled drugs. Taking these medications as prescribed can reduce the risk of developing dependence, but some people may still have this problem.

Alcohol and barbiturates can interact and cause a much stronger effect. This can cause severe drowsiness, passing out or trouble breathing. In severe cases, this could cause a person to have severe organ damage, or it could be deadly. However, barbiturates are still proven medications for treating many conditions. They also combine well with other medications like acetaminophen (Tylenol® or Paracetamol®) to treat certain conditions. People who survive an overdose of barbiturates may be left with permanent kidney damage.

1. In severe cases, barbiturate withdrawal is dangerous or even deadly.
2. Meningitis, encephalitis, sepsis, seizures, brain masses, cerebral edema, and intracranial hemorrhages may cause altered mental status and should be investigated if deemed likely according to the patient’s history.
3. Denial of a barbiturate to the habitual user may precipitate a withdrawal syndrome that is indicative of physiological dependence on the drug.

Thus, the use of these drugs has declined mainly in the last several decades in favor of agents with more favorable safety profiles. Despite a lower rate of barbiturate utilization overall, barbiturate toxicity is still a prevalent cause of significant morbidity and mortality that requires prompt and effective care to mitigate. With regular use, tolerance to the effects of barbiturates develops.

Barbiturates are a class of drugs derived from barbituric acid that act as depressants to the central nervous system. These drugs are used as sedatives or anesthetics and have the potential to become addictive. They’re problematic because there is no good treatment tremor national institute of neurological disorders and stroke to reverse a barbiturate overdose. A class of drugs known as benzodiazepines has largely replaced barbiturates for both medical and recreational use, although benzodiazepines also carry a high risk of physical dependence and other adverse effects.

Thiopental, introduced in 1934 for general anesthesia induction, served as the primary intravenous anesthetic induction agent until propofol replaced it. Barbiturates approved by the US Food and Drug Administration (FDA) for clinical use include phenobarbital, methohexital, butalbital, pentobarbital, primidone, and amobarbital. Barbiturates are classified according to their duration of action. Barbiturates of intermediate duration of action, such as amobarbital and butabarbital sodium, act for 6 to 12 hours and are used to relieve insomnia. Short-acting barbiturates, such as pentobarbital and secobarbital, are used to overcome difficulty in falling asleep.

Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered. If too much is used, it may become habit-forming (causing mental or physical dependence). Barbiturates are generally abused to reduce anxiety, decrease inhibitions, and treat unwanted effects of illicit drugs. For more information about barbiturates and misuse, visit eMedicine’s patient education articles “Drug Overdose,” “Drug Dependence and Abuse,” and “Substance Abuse.”

They can have adverse side effects when used in very high doses, and can be addictive when used for extended periods. This dependency and its adverse effects will be discussed further down. Consultation with a toxicologist or poison center can greatly assist with management and treatment decisions for barbiturate toxicity. Patients with severe barbiturate toxicity, cardiovascular collapse, or respiratory failure will need care in an intensive care unit. In the case of a suicide attempt, consultation with a psychiatrist should occur after the patient’s physical medical condition improves. The pharmacological actions of barbiturates include depressing nerve activity in the cardiac, smooth, and skeletal muscles.

There is one other interesting use for barbiturates in the field of psychology, law enforcement and the military. This application involves sodium pentothal in particular, more popularly known as the “truth serum”. This drug allows access to the levels of human consciousness that are normally only tapped in dream or trance state. The drug is therefore used mixing alcohol and antidepressants on traumatized WW2 soldiers during therapy. Under the influence of sodium pentothal, these soldiers are able to relive and better verbalize their battle experiences buried deep enough by voluntary recollection. The drug also takes away a person’s normal levels of inhibition, making them more forthcoming with information that they would otherwise withhold.

Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Data sources include Micromedex (updated 7 Jul 2024), Cerner Multum™ (updated 14 Jul 2024), ASHP (updated 10 Jul 2024) and others. Abrupt discontinuation of barbiturates in people who have been taking them for longer than one month can cause severe withdrawal symptoms, such as hallucinations, a high fever, and seizures. People with certain medical conditions are at higher risk of complications due to barbiturates especially as it is very likely that they are taking some medications to address their issues.